{include file=header.html}
<script src="{lib file=mlselection.js}" charset="utf-8"></script>
<script type="text/javascript">
$(function(){
    regionInit("region");
})
</script>
<div id="page-step">
	<div class="module step2">
    	<form method="post" enctype="multipart/form-data" id="apply_form" name="apply_form" class="J_AjaxForm">
            <table>
              <tr>
                <td><p><input type="text" name="owner_name" class="J_AjaxFormFields" value="{$store.owner_name|escape}" placeholder="{$lang.note_for_owner_name}"></p></td>
              </tr>
              <tr>
                <td><p><input type="text" class="J_AjaxFormFields"  name="owner_card" value="{$store.owner_card|escape}" placeholder="{$lang.note_for_owner_card}"></p></td>
              </tr>
              <tr>
                <td><p><input type="text"  name="store_name" class="J_AjaxFormFields" value="{$store.store_name|escape}" placeholder="{$lang.note_for_store_name}"></p></td>
              </tr>
              <tr>
                 <td>
                    <div class="select_add">
                       <label>{$lang.store_category}：</label>
                       <select name="cate_id" class="J_AjaxFormFields">
                         <option value="0">{$lang.select_pls}</option>
                          {html_options options=$scategories selected=$scategory.cate_id}
                      </select>
                    </div>
                  </td>
              </tr>
              <tr>
                 <td>
                    <div class="select_add" id="region">
                    	 <label>{$lang.region}：</label>
                         <input type="hidden" name="region_id" value="{$store.region_id}" class="mls_id J_AjaxFormFields" />
                         <input type="hidden" name="region_name" value="{$store.region_name}" class="mls_names J_AjaxFormFields" />
                         {if $store.region_name}
                         <span>{$store.region_name|escape}</span>
                         <input type="button" value="{$lang.edit}" class="edit_region" />
                         {/if}
                         <select class="d_inline"{if $store.region_name} style="display:none;"{/if}>
                              <option value="0">{$lang.select_pls}</option>
                              {html_options options=$regions}
                          </select>
                     </div>
                  </td>
                </tr>
              <tr>
                <td><p><input class="J_AjaxFormFields" type="text" id="address"  name="address" value="{$store.address|escape}" placeholder="{$lang.address}"></p></td>
              </tr>
        
              <tr>
                <td><p><input class="J_AjaxFormFields" type="text"  name="zipcode" value="{$store.zipcode|escape}" placeholder="{$lang.zipcode}"></p></td>
              </tr>
        
              <tr>
                <td><p><input type="text" class="J_AjaxFormFields" name="tel" value="{$store.tel|escape}" placeholder="{$lang.note_for_tel}"></p></td>
              </tr>
              
              <tr>
                <td>
                  <input type="checkbox" checked="checked" name="notice" class="J_AjaxFormFields" value="1" id="warning"> <label for="warning">{$lang.notice}</label>
                </td>
              </tr>
              <tr>
                <td>
                  <div class="btn mt20">
                  	<input type="hidden" class="J_AjaxFormSuccessRet J_AjaxFormFields" name="ret_url" value="index.php"  />
                    <input type="submit" value="立即开店" class="J_AjaxFormSubmit">
                  </div>
                </td>
              </tr>
            </table>
          </form>
    </div>
</div>
{include file=footer.html}
